Suicide a public health issue

I will never forget the deep sense of shock I felt when I heard that my sister-in-law had stepped in front of a high-speed train to kill herself.

This attractive young woman seemed to have everything to live for. She was a kind and loving wife, and was a talented artist. Beyond this, she was someone who was always quick with a smile and open to others with her big, caring heart.

My sister-in-law was the last person I would have considered to be at risk for suicide.

Now, several years later, the stigma and the pervasive sense of shame around her horrific death still lingers. But today I am not nearly so ignorant about the thoughts and feelings that might lead a loved one toward lethal self-injury.

I now recognize what an enormous – and potentially preventable – public health problem suicide is. Consider:

On average, one person in Kansas commits suicide every day. For each successful attempt, there are about 20 others who wind up in the hospital with self-inflicted injuries.

Suicide is most common in middle-aged and older adults, but suicide attempts peak in Kansas in persons 15 to 19 years of age. Males are 4.6 times more likely to die of suicide than females, and non-Hispanic whites are more than twice as likely to die of suicide than are Non-Hispanic blacks or Hispanics of any race.

Since the 1950s, suicide rates among adolescents and young adults have tripled. More teenagers and young adults die today from suicide than from cancer, heart disease, AIDS, pneumonia and influenza combined.

Suicide is now the 11th leading cause of death in Kansas, and our state’s rate of suicide is 13 percent higher than the national average.

What leads some people to kill themselves?

More than 90 percent of people who die from suicide have either a serious mental health disorder, such as major depression, or problems with substance abuse, particularly with alcohol. Many have both of these risk factors, but some have neither. In my sister-in-law’s case it was major depression, which I was unaware of.

What can be done to reduce the risk of suicide?

First, we can all learn the signs of acute suicide risk. Does your family member, co-worker, neighbor or friend exhibit signs of lost hope, social withdrawal, agitation, or worsening substance abuse? Are they talking about suicide or seeking lethal means? Pay particular attention if they have suffered from a triggering event recently.

If you see any of these signs, or suspect them, ask the person in a nonjudgmental way if she or he is thinking about suicide. Don’t worry that bringing up the topic of suicide will plant the idea in the person’s mind.

Just ask and listen for the reply. You could well be saving a life if you do.

If it turns out that the answer is yes, see that the person gets immediate help from their physician, mental health professional, or from the National Suicide Prevention Hotline, available 24 hours a day at 1-800-273-TALK (8255). And stay with them until they are safe.

In the long-term, we can prevent more suicides in Kansas by addressing many of the root causes of self-harm. We can build resilience in people at risk, by ensuring that they can access mental health and substance abuse treatment services, and by making sure that their primary care providers have the best training in recognizing suicide risk.

We can also do more to strengthen our connectedness as people, countering the isolation and self-doubt that commonly plagues people who are contemplating suicide. That means greater investment in social capital, whether it’s in civic organizations, faith communities or informal clubs and networks.

Our greatest protection against suicide is a caring community. I wish my sister-in-law had felt that care in time.

— Dr. Eberhart-Phillips is the Kansas state health officer and director of health in the Kansas Department of Health and Environment.

Dr. Eberhart-Phillips is the Kansas state health officer and director of health at the Kansas Department of Health and Environment.

I wouldn't say "callous and heartless," but I wonder how well informed you are. Did you read the article or just the headline? If you read it, you would learn (among other things) that suicide is the 11th leading cause of death in Kansas and that the state's rate is 13% higher than the national average. Also, for each suicide death, there are 20 attempts that send people to the hospital.

More than 90% of those who die from suicide have "a serious mental health disorder, such as major depression, or problems with substance abuse, particularly with alcohol." Some have both.

If suicides/attempted suicides do not impact public health, I don't know what does. The loss of these people in the work force, as breadwinners, in the family structure, directly impacts the functioning of their workplaces, financial solvency of their families, and the coping ability and emotional stability of loved ones. Suicide can lead to depression in other family members, causing an outward ripple of grief and lowered capacity to function effectively. Couple grief with sudden catastrophic loss of income, perhaps leading to foreclosure, and the domino effect can be swift and terrible. A parent's suicide can ripple through generations, with suicides often seeming to run in some families (see: Hemingway).

Another public impact is that many depressed individuals handle their depression by drinking--and driving. There may be a thinner line than we realize between a drunk driving "accident" and subconscious wish fulfillment---and when someone dies blind drunk behind the wheel, they may take others out with them.

Additionally, some suicidal people first kill others they think have harmed them (employers who have fired them) or dependents they can't stand to leave behind to fend for themselves. Despair can and has caused some to kill their entire families before ending their own lives.

Another public impact is sheer cost. Many who attempt suicide have no insurance--or they lose it after a first attempt. If they wind up in the ER, are rushed to emergency surgery, are on life support or in the ICU for lengthy periods of time, who do you think foots the bill? All of us, by way of higher insurance premiums, higher medical care costs, a depletion in Medicaid funds (our taxes), etc. If they survive, they may face job or relationship losses, more depression, another attempt, etc, as they spiral downward. Again, this impacts not just that person, but his or her family, social network, and all of us who have to cover (financially and otherwise) for someone who is debilitated or dies by a suicide attempt.

Those are just a few factors to consider. There are probably more I have missed.

We are all interconnected. George Bailey can't commit suicide without impacting you, me, our children, his own family, employer, and friends, and hundreds of others in direct or indirect ways--many we will never realize.

No...you missed my point or perhaps I was not as clear as I should have been. I do not consider this a public health issue, since whenever you call something a public anything you then open the floodgates to allowing the public to state how it is treated or dealt with.

Point in case you can look up several issues facing Law Enforcement today. Which is whenever they hear someone talk about hurting themselves whether flippantly or serious it allows them to some how then become a mental health professional and take the said person into custody whether voluntary or not to a hospital for "observation" for up to three days.

I personally think suicide is a horrible thing, but honestly if someone wants to take their own life it's there life to do with as they want. While I would hope that friends and family would dissuade them or get them help I do not want to see my public servants taking it upon themselves to force this person against their will to get help. This is not their job nor should it be, cause once you start down this path you open the flood gate to allowing the Govt to make decisions as to your sanity and allowing them to determine what is best for you even if you disagree.